HIV/AIDS Newsroom: January 26, 2001

Pfizer revealed that it has halted late-stage human trials of
capravirine, a potential blockbuster AIDS medicine, after a
year-long trial of the medication in dogs showed that very high
doses of the drug caused inflamed blood vessels, or vasculitis.
Pfizer said that the Food and Drug Administration is helping the
company to create further safety tests in animals. The firm
noted that none of the 650 human patients in six clinical trials
of capravirine had any indications of vasculitis. Most patients
will end their capravirine regimen in favor of other treatments,
but those who are doing well with the drug and have failed other
therapies will remain on the drug; both groups will be monitored
by Pfizer scientists.

White House press secretary Ari Fleischer reported that as
some of the special offices the Clinton administration
established are due to expire at some point, President Bush is
currently reviewing the statuses of both the Office of National
AIDS Policy and the Office on the President's Initiative for One
America. Fleischer noted that these offices perform "important
missions."

At a public hearing on HIV, Baltimore's health commissioner,
Peter Beilenson, announced that he would turn over the
responsibility of keeping count of the city's HIV cases to state
health officials. "I'm not confident we're doing it adequately,"
Beilenson said Wednesday. Last October the Maryland AIDS
Administration issued a report that was critical of the Baltimore
Health Department's HIV/AIDS monitoring. According to the study,
cases of AIDS and exposure to HIV are being underreported in the
city, and that could affect federal funding. Beilenson noted
that although no federal funds have been lost yet, that could
occur if the situation is not remedied. Beilenson said the state
will take over counting and reporting HIV/AIDS patients in the
city for 18 months. Meanwhile, the head of the state AIDS
administration agency noted that of the 2,111 new HIV cases
reported in Maryland in 1999, nearly 60 percent were in
Baltimore.

St. Louis Health officials tested hundreds of halfway house
residents for tuberculosis (TB) after one resident was reportedly
diagnosed with the disease. A spokesman for the Missouri
Department of Corrections noted that the tests may not have been
necessary, since further testing indicated that the patient has
bacterial pneumonia; city health officials are calling for
additional tests, however, suggesting that the man may have both
pneumonia and TB. Acting health director Hilda Chaski Adams
said, "We've asked them to take a second look, and we're going to
continue testing," particularly in case the man is infected with
a multidrug-resistant strain of TB. Adams noted that the man had
symptoms that appeared to indicate TB infection. There have been
nine cases of multidrug-resistant TB in St. Louis in the past
several years, eight of which were within one extended family.

According to a study by Dr. Grace C. John and colleagues from
the University of Washington in Seattle, another way to decrease
maternal-infant transmission of HIV-1 is to reduce the infant's
exposure to genital secretions or breast milk. The report,
published in the January 15th issue of the Journal of Infectious
Diseases (2001;183:206-212), notes that because so many
developing countries have restricted access to effective
antiretroviral drug therapy, intervention alternatives need to be
found. The authors investigated the issue among 92 HIV-infected
infants and 187 uninfected infants of HIV-seropositive women in
Kenya. The researchers discovered that the risk of
mother-to-child HIV transmission rose 80 percent with
breastfeeding, 130 percent with HIV DNA detection in vaginal
secretions during pregnancy, 170 percent with HIV DNA detection
in cervical secretions, and 290 percent with mastitis.

A study by Dr. Joep M.A. Lange and colleagues from the Academic
Medical Center in Amsterdam, the Netherlands, indicates that
HIV-infected patients with chronic hepatitis B virus or hepatitis
C virus infection have at least a three times higher risk rate of
developing a critical elevation in liver enzymes after starting
an antiretroviral program that contains a protease inhibitor,
versus patients who do not have hepatitis. According to the
report, published in the December 22nd issue of AIDS
(2000;14:2895-2902), the researchers felt that the antiretroviral
treatment need not be discontinued to reverse the hepatotoxicity
because the patient improvement would probably not be altered
either way. The authors emphasize that these test results only
apply to highly active retroviral therapies containing protease
inhibitors and the possibility of potentially fatal mitochondrial
toxicity may also exist with a regimen of nucleoside reverse
transcriptase inhibitors.

The death rate in Russia has overtaken the birth rate at a
ratio of 1.76 to one, prompting Russian officials to announce this
week that the nation's population will decline by at least 7.2 percent
by 2016, for a loss of about 10 million people. According to a
report by the Interfax news agency, Russia's population may drop
from 145 million now to less than 135 million over the next 15
years. Since the fall of the Soviet Union 10 years ago, Russia
has struggled with soaring rates of alcoholism, drug abuse, and
infectious diseases such as tuberculosis and HIV.

Ben Plumley, an official with UNAIDS, said Thursday that Rwanda
is very close to finalizing a deal for lower-priced AIDS drugs
with GlaxoSmithKline, Bristol-Myers Squibb, Merck, and Boehringer
Ingelheim. The prices for their antiretroviral drugs will likely
be between 60 percent and 90 percent lower than those charged to
the rest of the world, similar to deals already created with
Senegal and Uganda, said Plumley. An initiative was created in
May 2000 to develop a low-price AIDS drugs system for those
countries most in need, but progress has been slow as drug
companies insist on safeguards to prevent the low cost drugs from
flowing back into Western countries and undercutting the higher
prices there.

At a recent convention of the American Society of Hematology in
San Francisco, chemists from Vitex -- a Massachusetts drug
company -- presented results from the first human trials of a new
blood cleansing drug. The researchers developed a drug, called
Inactin, that is able to penetrate cell membranes and the protein
shells of viruses to release a positively charged assault
targeting the negatively charged DNA and RNA nucleus, rendering
the molecule unable to function. Red blood cells do not possess
a nucleus of DNA and RNA, so they remain unscathed by the Inactin
attack. Scientists believe that treatment with Inactin can
effectively decrease the amount of contamination from viral or
bacterial pathogens at the rate of 10,000 times or more.

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